Types of Anorexia:

Binge-Eating/Purging Type: During the episode
of Anorexia Nervosa, the person engages in recurrent episodes
of binge eating or purging

Restricting Type: During the episode of Anorexia
Nervosa, the person does not engage in recurrent episodes of binge
eating or purging

What is the difference between thinness and anorexia?

The central difference is the way in which the anorexic individual
experiences his/her body shape and size. An anorexic individual
is terrified of becoming fat or gaining weight, has stopped menstruating
because her body fat has dropped below a certain level, and has
a distorted sense of body size and shape (feels “fat”
even though s/he isn’t).

Warning Signs of Anorexia:

Preoccupation with food, calories, and weight

Weight loss in which the individual becomes increasingly thinner
and loses 15% or more of his/her ideal body weight for age and
height

Medical Complications of Anorexia:

Electrolyte imbalance which can produce life threatening complications

Cardiac irregularities

Insomnia, difficulty falling and staying asleep

Low tolerance for cold

Anemia

Growth of baby fine body hair

Reduced bone mass making individuals vulnerable to fractures
(adolescents and young women may be prone to fractures years after
their recovery)

Osteoporosis (an irreversible condition): predisposes individuals
to an increased risk of fractures during everyday activities such
as walking

Gastrointestinal complications

An increase in cholesterol levels despite the state of starvation

Elevated carotene levels which leads to a yellowish discoloration
of the skin

Cataracts, atrophy of the optic nerve (which can cause blindness),
and retinal degeneration may also accompany malnutrition

Anorexia is the leading cause of death in young women. At least
5 to 20% of all anorexic individuals will eventually die from the
disorder. Common causes of death among anorexics are starvation,
electrolyte imbalance (causing heart failure), and suicide (Barnhill
et al., 1998) .

What is Bulimia Nervosa?

The central characteristics of bulimia include:

Cycles of binge-eating and purging (self-induced vomiting, misuse
of laxatives, diuretics or enemas)

During a binge, an individual consumes large amounts of food
in a rapid, automatic, and subjectively out of control manner

Bingeing may serve to numb hunger, anger, and other feelings,
but eventually creates physical discomfort and anxiety about weight
gain

Medical Complications of Bulimia:

Damage to the heart and other muscle tissue from the use of
ipecac or other purgatives

Dental Problems: acid causes erosion of the enamel of the teeth,
creates gum abscesses, obstructs the salivary glands, creates
a propensity for cavities and the loss of fillings, ulcers on
the lips, and halitosis

Jitteriness, anxiety and irritability can be the result of an
excessive consumption of coffee, cola, and tea which is common
among individuals with eating disorders

Dehydration (which can cause lowered blood pressure)

Low potassium, sodium, chloride and magnesium levels caused
by self-induced vomiting, laxative and diuretic abuse are serious
problems that can lead to cardiac arrest and kidney failure

Purging may cause fluid retention in a rebound manner causing
edema of the hands and legs

Abnormalities in the menstrual cycle (among approximately 30%
of bulimic females)

Peptic ulcers and pancreatitis (inflammation of the pancreas)
occur at a higher frequency among bulimic individuals (pancreatitis
is a potentially life threatening consequence of bulimia)

Yellowish skin and hair loss from chronic protein malnutrition

Epileptic seizures from electrolyte imbalance and malnutrition,
as well as abnormalities in the electroencephalogram (EEG)

Anemias

Vitamin deficiencies may be the result of repeated bingeing
and purging

Mortality rates for bulimic individuals are unclear. However, some
experts assert that the death rate is as high or higher than for
individuals with anorexia (Barnhill et al., 1998).

Binge Eating Disorder (formerly referred to as compulsive eating):

Central characteristics include:

Periods of impulsively consuming very large amounts of food
in a relatively short period of time, or continuous eating while
experiencing feelings of being out of control

While there is no purging, there may be sporadic fasts or repetitive
diets

Body weight may vary from normal to mild, moderate or severe
obesity

How do I know if I have an eating disorder?

Take the following True/False Quiz

I often feel fat, even though people keep telling me I’m
thin.

The first thing I think about when I wake up in the morning
is food.

I feel uneasy about food and eating, but I keep my feelings
to myself because no one would understand.

I have dieted to an abnormally low weight because that makes
me feel like I’m in
control.

I haven’t had a menstrual period for at least the past
three months.

I often eat when I’m not hungry.

My greatest fear is that I’ll gain weight and become
fat.

I can’t go through a day without worrying about what
I can or cannot eat.

I have had an out of control eating binge at least once during
the past year.

I often eat until I’m so full I feel uncomfortable.

I have done one of the following after a binge at least once
during the past year:
made myself vomit; used laxatives, enemas, colonics, or diuretics;
fasted;
exercised excessively.

If I got on the scale tomorrow and found out that I’d
gained two pounds, I’d be very
upset.

If I can’t exercise to compensate for food I have eaten,
I panic.

I push food around my plate so that it looks like I’m
eating more than I really am.

Often I eat to make myself feel better emotionally, but then
I feel guilty about it.

I prefer to eat little in public; then I binge secretly in
private.

I think and talk a lot about food, recipes, weight, diets,
restaurants, and other topics
related to food.

People always seem to be bothering me about what I’m
eating or not eating, which
makes me angry.

I don’t believe I’ll be able to find happiness
until I’m thin.

It’s important to me to be thinner than my friends.

If you marked any of the statements above “true” (particularly
4,5,7,8,11,13,16 or 19), you may have an eating problem (Barnhill
et al., 1998, p.43-44).

If you would like to talk further about any thing related to issues
with eating please contact the University of the Sciences Counseling
Center.

Appointments can be scheduled either in person or by phone through
the Counseling Center front desk at 215.596.8536. In person - come
to the 1st floor of Whitecar Hall.

In the event of an emergency or crises after regular office hours
call campus security at 215 596-7000 to initiate emergency procedures.

What Family and Friends Can Do

Communicate your concern to the person; express that you would
like to help and that you are ready to listen.

Try to avoid talking about topics related to food, calories, weight,
and exercise; try to focus on talking about feelings underneath
the eating disordered behaviors. Also, try to avoid engaging in
a power struggle with the person about his/her behaviors.

Encourage the person to seek professional help, keep in mind that
the decision to seek help is ultimately up to the individual.

Certain situations may necessitate getting immediate help for the
person including: bingeing, purging or starving to the point that
the person is too weak or sick to function, if the person is unable
to keep any food down, and if the person is engaging in self-harm
behaviors or is suicidal.

Resources in the Philadelphia Area:

AA/BA of Philadelphia (American Anorexia /Bulimia Association)
Support groups for individuals with anorexia and bulimia (twice
a month); separate support groups for families and friends (twice
a month); monthly informational meetings with guest speakers; and
referrals for psychological and medical services. For information
call the AA/BA of Philadelphia at 215.221.1864

Belmont Center For Comprehensive Treatment 215.581.5489

The Renfrew Center in Philadelphia. Renfrew specializes
in the treatment of eating disorders. In addition to the residential,
day and intensive outpatient programs, a support group open to the
public takes place every Friday and Saturday night for individuals
with eating disorders and their families and friends. For information
call 1.800.RENFREW or visit www.renfrew.org

University of Pennsylvania Weight and Eating Disorders
Program. Penn offers participation in research studying
eating disorders including free behavioral and nutritional treatment
for those who qualify. For information call 215.898.7314